Maternal hemodynamics in severe pre-eclampsia with fetal growth restriction demonstrated an hypodynamic profile

Maternal hemodynamics can be evaluated with simple-to-use, non-invasive devices, that are affordable in low resource settings. The aim was to assess maternal hemodynamics in patients with severe pre-eclampsia with and without fetal growth restriction (FGR). A multicentre prospective cohort study was conducted in Colombia, a middle-income country, including patients with severe pre-eclampsia admitted to the emergency department. Bioreactance was used to assess hemodynamics variables, and fetoplacental Doppler evaluation was performed. FGR was defined as a birthweight < 10th centile. Between-group comparisons were performed using the student's t-test or Mann–Whitney U tests to examine the differences. In addition, Pearson's chi-square test was used to determine differences in proportions. 110 patients were included, 60 (55%) without FGR and 50 (45%) with FGR. Women with severe pre-eclampsia and FGR had significantly lower cardiac output and higher peripheral vascular resistance than those with normally grown fetuses: 6.41 (± 1.65) vs. 7.1 (± 1.69) lt/min, (p = 0.032) and 1277 (1068-1457) vs. 1102 (944-1383) dyns/cm5, (p = 0.04), respectively. There were no differences in the delivery oxygen index between the groups (p = 0.828). Patients with severe pre-eclampsia and fetal growth restriction present with hemodynamic characteristics that suggest a hypodynamic profile. Future studies could explore whether aiding these evaluations might be useful in the identification of patients with a more severe clinical phenotype.